Podcast
Questions and Answers
Which muscle is innervated by the recurrent branch of the median nerve?
Which muscle is innervated by the recurrent branch of the median nerve?
What is the main innervation of the Adductor Pollicis muscle?
What is the main innervation of the Adductor Pollicis muscle?
Which muscles are responsible for the swelling at the base of the little finger?
Which muscles are responsible for the swelling at the base of the little finger?
What is the function of the dorsal interossei muscles?
What is the function of the dorsal interossei muscles?
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Which nerve innervates the medial two lumbricals?
Which nerve innervates the medial two lumbricals?
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Which artery primarily supplies the thumb and lateral side of the index finger?
Which artery primarily supplies the thumb and lateral side of the index finger?
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What completes the superficial palmar arch?
What completes the superficial palmar arch?
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Where does the deep palmar arch primarily lie?
Where does the deep palmar arch primarily lie?
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Which artery gives rise to the princeps pollicis artery?
Which artery gives rise to the princeps pollicis artery?
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What does the dorsal carpal branch of the radial artery contribute to?
What does the dorsal carpal branch of the radial artery contribute to?
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What structure holds the long flexor tendons in position at the wrist?
What structure holds the long flexor tendons in position at the wrist?
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Which of the following supplies the medial aspect of the forearm?
Which of the following supplies the medial aspect of the forearm?
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Which nerve supplies all intrinsic muscles of the hand except for the thenar muscles?
Which nerve supplies all intrinsic muscles of the hand except for the thenar muscles?
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Which nerve passes deep to the flexor retinaculum?
Which nerve passes deep to the flexor retinaculum?
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Which of the following is a component of the carpal tunnel?
Which of the following is a component of the carpal tunnel?
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Which structure is attached laterally to the anterior border of the radius?
Which structure is attached laterally to the anterior border of the radius?
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Which group of hand muscles originates outside the hand?
Which group of hand muscles originates outside the hand?
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Which artery contributes to the formation of the dorsal metacarpal arteries?
Which artery contributes to the formation of the dorsal metacarpal arteries?
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What are the three muscles responsible for the thenar eminence?
What are the three muscles responsible for the thenar eminence?
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What provides sensory innervation to the dorsolateral side of the hand?
What provides sensory innervation to the dorsolateral side of the hand?
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What structure is comprised of the union of the dorsal carpal branches from the radial and ulnar arteries?
What structure is comprised of the union of the dorsal carpal branches from the radial and ulnar arteries?
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Which nerve is located superficial to the flexor retinaculum?
Which nerve is located superficial to the flexor retinaculum?
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What forms the fibro-osseous canal at the wrist?
What forms the fibro-osseous canal at the wrist?
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What is the role of the palmar cutaneous branch of the ulnar nerve?
What is the role of the palmar cutaneous branch of the ulnar nerve?
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Study Notes
Hand Anatomy
- Anatomist and Co-Leader: Dr. Redir T Hassan, co-leader of the MSK module and Phase 1 leader at the College of Medicine, University of Duhok.
Hand Objectives
- Objective 15: Understanding, explaining, and demonstrating movements of forearm muscles (extrinsic and intrinsic).
- Objective 18: Identifying and locating major nerves, their distribution (motor and sensory - dermatomes), and consequences of injuries.
- Objective 19: Describing principal arteries and veins of the upper limb, locating arterial pulses and sites for venipuncture/transfusion.
- Objective 24: Identifying superficial structures (tendons, blood vessels, nerves) at the wrist and their injury consequences.
Hand Bones
- Phalanges (fingers): Distal, middle, proximal.
- Metacarpals (palm): Bones numbered 1-5.
- Carpals (wrist): Hamate, Pisiform, Triquetrum, Lunate, Scaphoid, Capitate, Trapezium, Trapezoid (in order from anatomical position).
- Radius and Ulna: Forearm bones.
Flexor Retinaculum
- Description: Thickening of deep fascia, holding long flexor tendons in position at the wrist.
- Attachments: Medially to the pisiform and hamate bones, laterally to the scaphoid tubercle and trapezium bones.
Structures Passing Deep to Flexor Retinaculum
- Lateral to Medial: Flexor digitorum superficialis tendons, median nerve, flexor pollicis longus tendon, flexor carpi radialis tendon.
Structures Passing Superficial to Flexor Retinaculum
- Lateral to Medial: Ulnar nerve, ulnar artery, palmar cutaneous branch of ulnar nerve, palmar longus tendon, palmar cutaneous branch of the median nerve.
Carpal Tunnel
- Description: Fibro-osseous canal anteriorly at the wrist, formed by a deep arch of carpal bones and the flexor retinaculum.
- Contents: Tendons of FDS, FDP, FPL and the median nerve.
Hand Muscles (Groups)
- A. Extrinsic Muscles: Originate outside the hand and insert into hand bones (e.g., FDS, FDP).
- B. Intrinsic Muscles: Five groups within the hand – Thenar eminence (Opponens pollicis, Flexor pollicis brevis, Abductor pollicis brevis), Hypothenar eminence (Opponens digiti minimi, Abductor digiti minimi, Flexor digiti minimi brevis),interossei (dorsal and palmar). lumbricals muscles.
Thenar Eminence
- Description: Prominent swelling on the lateral side of the palm at the base of the thumb.
- Muscles: Opponens pollicis, flexor pollicis brevis, abductor pollicis brevis.
- Innervation: Recurrent branch of median nerve.
Adductor Pollicis
- Origin: Two heads (transverse and oblique) from metacarpals 3, 2 and 3.
- Insertion: Medial side of proximal phalanx of thumb.
- Function: Adduction of thumb.
- Innervation: Deep branch of ulnar nerve.
Hypothenar Eminence
- Location: Base of little finger.
- Muscles: Opponens digiti minimi, abductor digiti minimi, flexor digiti minimi brevis
- Innervation: Deep branch of ulnar nerve.
Interosseous Muscles
- Description: Between metacarpals, inserted into proximal phalanges of each digit.
- Types: Dorsal interossei (abduction), palmar interossei (adduction).
- Innervation: Deep branch of ulnar nerve.
Lumbrical Muscles
- Description: Worm-like muscles associated with each finger.
- Origin: Tendons of flexor digitorum profundus in the palm
- Innervation: Medial two – deep branch of ulnar nerve; Lateral two – digital branches of the median nerve.
- Action: Flex MPJ and extend IPJ.
Blood Vessels of the Hand
- Arteries: Radial artery (thumb and lateral index finger), ulnar artery (remaining digits and medial index finger). Interconnected arches (superficial and deep).
- Veins: Deep veins follow arteries. Superficial veins drain into a dorsal venous network over metacarpals. Cephalic and Basilic veins are main superficial veins.
Nerves of the Hand
- Ulnar nerve innervates all intrinsic hand muscles except the three thenar muscles and two lateral lumbricals, which are innervated by median nerve.
- Radial nerve innervates skin on the dorsolateral side of the hand.
Extensor Retinaculum
- Description: Strong, fibrous band extending across the posterior wrist.
- Attachments: Laterally to the anterior radius border and medially to the triquetral and pisiform bones.
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Description
This quiz covers key concepts of hand anatomy, including the bones, muscles, nerves, and blood vessels involved. It emphasizes understanding the movements and injuries related to the forearm and hand structures. Test your knowledge on the anatomical features and their implications for functioning.
